Please consider me for:
Name *
Name
Address
Address
Home Phone
Home Phone
Work Phone
Work Phone
Other Phone
Other Phone
Referred By
Age
Eligible to work in the U.S.?
Veteran of the U.S. Military?
Do you possess a valid driver's license?
Have you been convicted of a felony within the past seven years?
Are you seeking?
Are you able to work weekends and holidays?
Are you willing to work?
REFERENCES
Name: Phone: Address: Business: Years Known:
Name: Phone: Address: Business: Years Known:
Name: Phone: Address: Business: Years Known:
EMPLOYMENT HISTORY
May we contact?
May we contact?
Were you employed by any of these under a different name?
AGREEMENT & SIGNATURE
My signature below certifies that I have completed this application honestly and all information is true and correct. I understand that it is RSI's right to check references and former employers to inquire about my work hisory and work ethics. I authorize all references, former employers, credit agencies, educaional institutions, law enforcement agencies, city, state, and federal courts as well as military services to release information about my background. I understand that an inquiry into my background will be made before any employment offer is made. Any misrepresentation or omission of any facts in my application, resume, or other materials can be justification for refusal of employment, or if employed, termination. I also understand that if an offer of employment is made, I am willing to submit to a criminal background check. I also understand my employment and compensation can be determined with or without cause or notice, at any time, at the option of either the company or myself. Finally, I understand this application is not an offer of employment.

Click SUBMIT above and you are done.

We look forward to reviewing your application. Thank you.